The objective of this study was to compare the effects on eating behavior, lipids, lipoproteins, lipid peroxidation, and glycemic control in women with type 2 diabetes of a high-monounsaturated fat diet (HM) compared to a high-carbohydrate diet (HC). In an outpatient feeding study, ten hypertriglyceridemic postmenopausal type 2 diabetic women alternately for six weeks consumed the HM and HC diets. On the HM diet, 45% of total calories were consumed as carbohydrate and 40% as fat (27% monounsaturated) compared to 55% carbohydrate and 30% fat (10% monounsaturated) in the HC diet. At the beginning and end of each diet phase, total lipids, lipoproteins, lipid peroxidation, and glycemic variables were measured. For 8 days in each diet phase eating pattern frequency, palatability of foods, hunger and fullness were assessed. At the end of each diet phase, taste testing to determine preference for fat was conducted. Total cholesterol was significantly decreased on the HC diet. Serum triglyceride, very low density lipoprotein (VLDL) triglyceride and cholesterol, and apolipoproteins A-1 and B were not significantly different on the two diets. When comparing initial to final values, both diets lowered LDL-C; however, the change was greater on the HM diet. Lipid peroxidation variables improved when the HM diet was consumed. Glycemic variables improved on both diets. No significant differences between total number of eating episodes on the HM and HC diet phases were found. Both diets were rated as highly palatable. Hunger and fullness ratings varied within and between subjects. However, fullness was more commonly experienced than hunger on both HM and the HC diet. Preference for fat was not found at the end ofHM or HC diets. However, subjects differed significantly in ratings for liking of foods that were salty, sour, and bitter when compared to nondiabetic women. Consumption of the HM and HC diets did not result in deterioration of lipid status. The HM diet by virtue of less oxidation of the LDL particle and improvement of glycemic control provides an important advantage over the HC diet. A description of eating behavior of women with type 2 diabetes emerged. / Graduation date: 2000

While replacement of dietary saturated fat with unsaturated fat has been advocated to reduce cardiovascular disease risk, diets high in polyunsaturated fatty acids (PUFA) could increase low density lipoprotein (LDL) susceptibility to oxidation, potentially contributing to the pathology of atherosclerosis. To assess in vivo lipid peroxidation and susceptibility, of LDL surface and core lipids to ex vivo oxidation, in women consuming increased amounts of specific unsaturated fatty acids, 15 postmenopausal women took daily supplements of sunflower oil providing 12.3 g/day of oleate, safflower oil providing 10.5 g/day of linoleate, and fish oil providing 2.0 g/day of eicosapentaenoate (EPA) and 1.4 g/day of docosahexaenoate (DHA) during a crossover trial. Plasma F₂-isoprostanes (F₂-isoP), malondialdehyde (MDA), and thiobarbituric acid reacting substances (TEARS) were measured to assess lipid peroxidation in vivo. Ex vivo oxidation of LDL was monitored by measuring the formation of phosphatidylcholine hydroperoxides (PCOOH) and cholesteryl linoleate hydroperoxides (CE18:200H) during coppermediated oxidation. Plasma free F₂-isoP and MDA concentrations were lower after EPA/DHA supplementation than after oleate (P = 0.001, F₂-isoP and 0.02, MDA) and linoleate supplementation (P = 0.04 for both F₂-isoP and MDA). However, plasma TBARS concentrations were higher after EPA/DHA than after oleate (P = 0.001) and linoleate supplementation (P = 0.0004). During LDL oxidation, the lag phase for PCOOH formation was shorter in EPA/DHA- than oleate- (P = 0.0001) and linoleate-enriched LDL (P = 0.002), while the lag phase for CE18:200H was shorter in EPA/DHA- than oleate- (P = 0.01) but not linoleate-enriched LDL. The maximal rate of PCOOH formation was lower in EPA/ DHA- than linoleate- (P = 0.007) but not oleate-enriched LDL, while the maximal rate of CE18:200H formation was lower in EPA/DHA- than oleate- (P = 0.03) and linoleate-enriched LDL (P [less than or equal to] 0.0001). The maximal concentrations of PCOOH and CE18:200H were lower in EPA/DHA- than oleate- (P [less than or equal to] 0.05) and linoleate-enriched LDL (P [less than or equal to] 0.01). Oleate-enrichment generally decreased the oxidative susceptibility of LDL surface and core lipids, while EPA/DHA-enrichment did not increase LDL oxidative susceptibility compared to linoleate-enrichment. This study emphasizes the need for more than one relevant assay of in vivo lipid peroxidation. / Graduation date: 2000

Given the high risk of relapse during the first year of exercise involvement, it is important to determine the processes of self-motivation which enable novice exercisers to become long-term maintainers. This study was designed to extend previous Stages of Change (Prochaska & DiClemente, 1983) research by comparing the Possible Selves (Markus & Nurius, 1986) of individuals at different points within the Maintenance stage of exercise. Participants consisted of female university employees, spouses, and dependents age 35-59 years who volunteered for the study. Participants completed the Stage of Exercise Scale (SOES; Cardinal, 1995) and a self-administered form of the Possible Selves Inventory (Cross & Markus, 1991) which was adapted to address the exercise domain. Women classified by the SOES as being in the Maintenance stage of exercise V=92) were assigned to one of three groups based on the duration of their exercise maintenance (6 months-5 years, 6-10 years, and 11-20 years). The three maintenance groups were compared with regard to the number and category of open-ended and exercise-related possible selves and the self-efficacy and outcome expectancy associated with three focused selves (most important, exercise-related, and exercise-specific). The results indicated that the three maintenance groups did not differ significantly in their possible selves. These findings provide support for the current conceptualization of the Stages of Change Model (Prochaska & Di Clemente, 1983) and suggest that differences between novice and expert maintainers may be behavioral, rather than cognitive, in nature. Several implications for intervention design and suggestions for future research are discussed. / Graduation date: 1998

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Conclusion. We observed a small but independent effect of soy intake and lipid lowering effect, even after taking into account the other important predicting factors - initial cholesterol, body composition, physical activity, dietary intake and age. The beneficial effect between soy protein intake and lipid profile were observed even with this relatively low level of soy protein consumption suggests that the effect of soy protein supplement use on lipid profile may be much greater than those observed here. The results of our study add to the existing evidence that soy protein may be beneficial in human lipid profile. Our data will be useful for planning effective education programs as well as providing background information for further interventional studies to prevent coronary heart disease. / Coronary Heart Disease (CHD) is the major cause of death in most developed countries and is rapidly increasing in developing countries. Recent studies showed that natural menopause confers a threefold increase in CHD risk. While many risk factors, such as hypertension, diabetes mellitus, obesity and physical inactivity contribute to the risk for CHD, lipid abnormalities are the major factor. Hyperlipidemia plays a central role in the atherosclerotic process. Recent studies showed that consuming soy, a food containing large amounts of soy protein, improves the plasma lipoprotein profile by decreasing total cholesterol, LDL cholesterol, triglycerides as well as increasing HDL level. Although soy is a main component of traditional Asian food, many of the studies on soy consumption have been conducted in Caucasian populations (table 1.2), among whom soy intake is rather low or almost nil, it was difficult to explore the association of soy protein intake and lipid profile in those populations. Soy products such as tofu and soymilk are traditional Chinese foods. With the changing dietary pattern, it gives rise to a range of intake from traditional to modern and increasing incidence of cardiovascular disease Hong Kong poses a unique opportunity for the investigation of the relation between soy protein intake and lipid profile. / For baseline age stratified subgroup analysis, our study results showed no association between soy protein intake and lipid pro file in women whose baseline age younger than 55.3 years old, but we did observe a positive association in women belonging to older subgroup. In the 12-month follow up analysis, for women whose baseline age was older than 55.3 years (mean age=58.4+/-2.1), after controlling for the potential confounders, soy protein intake was significantly associated with HDL cholesterol concentration (Linear Regression p=0.033, ANCOVA=0.011, P value for trend p=0.014), total cholesterol/HDL ratio (Linear Regression p=0.045) and LDL/HDL ratio (Linear Regression p=0.037). Similar observation was observed in the yearly change rate of HDL in 24-month follow up (Linear Regression p=0.047, P value for trend p=0.043). / For women whose initial cholesterol level was higher or equal to 200mg/dL, in our 2-year longitudinal analysis, after controlling for the potential confounders, soy protein intake was significantly associated with HDL (Linear Regression p=0.041) and cholesterol/HDL ratio (ANCOVA=0.022). We also observed a statistically significant trend for higher HDL cholesterol (p=0.038), with an increase of 11.4g in soy protein intake between the 1st and 3rd tertiles, our data showed a 3.8% increase in HDL. / In the 12-month longitudinal analyses, after controlling for the potential confounders, soy protein intake was significantly associated with HDL concentration (Linear Regression p=0.036). We also observed a statistically significant trend for higher HDL cholesterol (p=0.036), with an increase of 10.9g in soy protein intake between the 1st and 3rd tertiles, our data showed a 7.9% increase in HDL. / Methods. 307 women aged between 48 to 62 years were recruited from community subjects residing in housing estates in Shatin. Women within the first 12 years of menopause, with no history of malabsorption syndromes, chronic liver kidney diseases, parathyroid diseases, gastric operation or cancer and without currently taking lipid lowering therapy were included in the study. We estimated the dietary intake of soy foods and other key nutrients by using quantitative food frequency method. We recorded serum values of fasting cholesterol, LDL cholesterol, HDL cholesterol and triglycerides as well as other covariance measurement. Soy protein consumption was categorized as tertiles of intake and related to lipid profile. / Objectives. In order to study the relation between soy protein intake and lipid profile in the early postmenopausal Chinese women in Hong Kong, we conducted the study from February 2000 to February 2002, as a part of the population-based soy consumption and bone mineral density study. The hypothesis to be tested is that high intake of dietary soy protein has a beneficial effect on lipid profile in the early postmenopausal Chinese women in Hong Kong. / Results. In our cross-sectional analysis, our findings showed that habitual dietary soy protein intake had a weak but statistically significant correlation with triglyceride concentration (Linear Regression p=0.045, ANCOVA p=0.045 P value for trend p=0.023), and the soy protein beneficial effects were more pronounced in women whose % of total body fat were higher than 33.4%. After controlling for the potential confounders, soy protein intake was significantly associated with triglyceride concentration (Linear Regression p=0.048, P value for trend =0.021), the average decrease in triglycerides were 24.6% and 29.1 % in the 2nd and 3rd tertile compared with the 1st tertile respectively. / Lam Siu Hung. / "February 2006." / Adviser: Ho Suzanne Sutying. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6300. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 181-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Background and objective. Ultrasonic evaluation of carotid intima media thickness (IMT) has been widely used as a surrogate of atherosclerosis. Few studies have specifically examined risk factors related to subclinical atherosclerosis (SA) among early postmenopausal women, in particular in the Chinese population. There is also little information on the distribution of IMT in Asian midlife women. We described the prevalence of SA, as determined by IMT and carotid plaque, and the associated risk factors in early postmenopausal Chinese women in Hong Kong. / Conclusions. Our findings showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT, while age, LDL-C, and abdominal obesity were independent predictors of the presence of plaque. The optimal IMT cutoff of 0.783 mm was defined and that a prevalence of SA (IMT ≥ 0.783 mm) of 38.6% was found among 'healthy' early postmenopausal Chinese women in Hong Kong. / Methods. 518 women aged 50 to 64 years, and within 10 years since menopause were recruited from random telephone dialing. Women with surgical menopause, established cardiovascular diseases (CVD), and severe disease conditions such as cancer and renal failure were excluded. Sociodemographic, anthropometric and lifestyle factors were obtained based on standardized questionnaires. Fasting blood sample was also obtained. B-mode ultrasound was used for measuring IMT at 12 sites of the carotid arteries and plague index, which is the sum of the grades (ranged from 0 to 3) at the 6 segments. The relations between traditional risk factors, and other potential risk factors such as inflammatory markers, as well as lifestyle factors including physical activity, dietary intake, and psychological factors with SA were also assessed. / Results. The mean IMT +/- SD was 0.76 +/- 0.12 mm, with a range from 0.53 to 1.00 mm. IMT was higher on the far wall than on the near wall (P<0.01), and differ among segments (greatest at the bulb and least at the ICA) (P<0.01). One-fifth of women had at least 1 plaque in the carotid artery with most of the plaque occurred in the bulb area. IMT increased with age, and was positively associated with carotid plaque. With the use of receiver operating characteristic curve (ROC) analysis, the optimal cutoff IMT for diagnostic plaque was 0.783 mm, at which sensitivity and specificity was 80.5% and 75.1%, respectively. The prevalence of SA was 38.6%. Among the traditional risk factors, systolic blood pressure (SBP), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were associated with high IMT. Abdominal obesity assessed by waist circumference (WC) and waist hip ratio (WHR) was also found to be positively associated with IMT. Stepwise multiple regression showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT. Multiple logistic regression showed that women with LDL-C ≥ 130 mg/dL were associated with a 2.4-fold (95% CI 1.5-3.7) higher risk of having plaque compared to those with LDL-C < 130 mg/dL. In addition, women with abdominal obesity (WHR ≥ 0.85) had a 1.7-fold (95% CI 1.08-2.67) higher risk of having plaque than women with WHR < 0.85 after adjustment for age, and potential confounders including physical activity, dietary intakes etc. Significant inverse associations were observed between physical activity and indices of obesity, as well as fasting blood glucose, while psychological perceived stress and trait anxiety were independent risk factors for both total cholesterol and LDL-C. / Yu Ho-yan. / "February 2006." / Adviser: Suzanne C. Ho. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6350. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 220-256). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

The purpose of this study was to determine if a 5-month progressive-resistance exercise program would affect measures of activities of daily living (ADLs) and functional stability in elderly women. All subjects were ambulatory women, 80 to 93 years old, who lived in assisted-care facilities. Eight exercise and 7 control subjects completed the 5-month study. Exercise subjects participated 3 times weekly in progressive resistance of the lower extremities and upper extremities. ADLs were assessed by the Barthel Index, and functional stability was assessed by timed measures of rising from a chair, walking, and standing, feet together, with eyes open and eyes closed. All subjects were tested at 0, 10, and 20 weeks. Using repeated measures analysis of variance, significant differences were seen only in an overall Group effect (p<.0005). The Eyes Open stance (p=.02) and Walk (p=.01) measures contributed most to this effect. The lack of significance in other analyses may have resulted from low sample size, high variation of scores, initial group differences, or perhaps an ineffective treatment program. / Graduation date: 1997

Numerous cross-sectional studies have reported an inverse relationship between VO2,,,ax and age. However, few longitudinal investigations have compared the rate of decline in VO2,,.x between women who did or did not report exercise habits consistent with the 1990 ACSM position stand for quantity and quality of exercise. The purpose of this study was to determine if changes in exercise habits and body composition affected age-related changes in VO2.x. Subjects were 91 women (age 40.9 ± 8.8 years at baseline) tested twice between 1973 and 1996 (range of 3.1 - 21.9 years, mean interval of 9.3 ± 4.2 years). The subjects were divided into four physical activity groups based on their reported exercise habits at baseline and follow-up as: non-exercise - exercise (NE-EX; n = 21), NE-NE (n=36), EX-EX (n=19), and EX-NE (n=15). Baseline VOz,,,ax (ml-kg-1-min-1) was significantly higher for the EX vs. NE ( 38.4 ± 8.4 vs.28.8 ± 5.7; f42.2; P<.0001). ANOVA revealed significant differences between the physical activity change groups and mean percent changes in VO2. (% A ml•kg'.min'-yr') (F =10.887; P<.0001) which are listed in the following:NE-NENE-EXEX-EXEX-NE-1.081.58*-1.25-2.21* NE-EX vs. EX-NE; NE-EX vs. EX-EX; and NE-EX vs. NE-NE (P<0.05)There were differences between the following groups: NE-EX vs. EX-NE; NE-EX vs. EX-EX; and NE-EX vs. NE-NE for percent change in VO2max (nl•kg'-min 1•yr 1) with the EX-NE group having the largest decline in VO2max during the follow-up period.Using a multiple regression model after adjusting for the exercise habit groups, the exercise group scheme accounted for 27.3 percent of the variance in percent change in VO2max at step 1 of the analysis (f = 1.09; P < 0.001). Change in percent body fat and change in maximal ventilation accounted for an additional 7.2 percent and 6.5 percent of the variance at steps 2 and 3, respectively. The change in maximal heart rate accounted for an additional 2.5 percent of the variance at step 4, although the statistical significance of the contribution was low (P = 0.057). Increases in body fat and decreases in pulmonary ventilation were found associated with declines in aerobic power while a decline in maximal heart rate between the tests was associated with a decline in percent change in aerobic power.In conclusion, these data demonstrate that: 1) adoption or maintenance of a regular exercise program is associated with less decline in VO2,,. during long-term follow-up compared to women who did not exercisers, and 2) changes in exercise habits, body composition, maximal ventilation, and maximal heart rate accounted for nearly half (43 %) percent of the percent decline per year. / School of Physical Education

Graduation date: 2000

This descriptive correlational study was designed to increase the knowledge needed to understand the relationship among health-related variables that facilitate or sustain health-promoting behaviours of midlife women. Specifically, this study investigated the relationship among self-esteem, health locus of control, and health-promoting behaviours of women in this age group. Pender's (1982) original Health Promotion Model provided the theoretical framework to structure this study. The sample included 84 midlife women volunteers who were current or prospective members of a Vancouver-based social networking group for mature women. Data were collected using the Rosenberg (1965) Self-Esteem Scale, the Multidimensional Health Locus of Control Scale -Form A, and the Health-Promoting Lifestyle Profile. Data were analyzed using descriptive statistics, Pearson's product-moment correlations, and stepwise multiple regression. Three significant predictors, self-esteem, chance health locus of control, and powerful others health locus of control, explained 24.5% of the variance for engaging in health-promoting behaviours. The study findings supported Pender's Model which postulated that individual perceptions of self-esteem and health locus of control, among other personal factors, influence one's likelihood of engaging in health-promoting behaviours. The findings also supported Pender's contention that selected demographic variables, as modifying variables, have an impact on health-promoting behaviours. / Applied Science, Faculty of / Nursing, School of / Graduate